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Rebecca Voelker

JAMA. 1999;282:723.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Summer may be winding down, but researchers at Stanford University Medical Center remind physicians to consider the possibility of tick-borne disease in patients with pulmonary symptoms.

"If a patient presents with pulmonary symptoms and gives a history of a recent tick bite, a pulmonary complication caused by a tick-borne disease should be considered in the differential diagnosis," the researchers wrote in the July issue of Chest. They noted that even though Lyme disease usually is not associated with respiratory symptoms, cough has been reported in some patients with the illness. In stage 2 Lyme disease, shortness of breath may result from cardiac involvement or phrenic nerve palsy.

However, pulmonary symptoms are more common in patients with Rocky Mountain spotted fever: cough occurs in about 33%, pharyngitis in 8%, pleuritic chest pain in 17%, and up to 36% have a pleural effusion on the chest radiograph. Tularemia, which . . . [Full Text of this Article]

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